VASKULÄR MEDICIN - Mediahuset i Göteborg AB

Slutsats
Vi har till slut fått data från en randomiserad
prospektiv studie, PREDIMED, som
talar för att en relativt fettrik medelhavskost
passar för patienter med såväl fetma
som diabetes och som minskar sjuklighet
jämfört med den mer traditionella lågfettkosten.
Fibrer bör man nog undvika om
man inte absolut behöver dem för att hålla
igång magen. Avseende lipidbehandling
vid diabetes är det visserligen svårt att på
säker bas ange målvärden, men flera statiner
har visat mycket god effekt att minska
sjukligheten. Blodtrycksbehandling vid
diabetes bygger på en kombination av flera
preparat och ambitionen bör vara att nå
väl under vad som är målet vid hypertoni
utan samtidig diabetes. Slutligen så talar
mycket för att det är en fördel om man
kan behandla hyperglykemin med preparat
som inte förorsakar hypoglykemier, och
givetvis uppskattar patienten om man inte
ökar i vikt av behandlingen. Vi börjar nu
få endpointdata för inkretinbaserad terapi
samtidigt som vi nu också får en helt ny
typ av diabetespreparat under 2013, de
så kallade gliflozinerna, som sänker blodsockret
efter måltid genom ökad glukosuri
vilket är en mekanism som också sänker
kroppsvikten.
Fredrik Nyström
Professor, Linköping
Staffan Lindeberg
Docent, Lund (avsnittet om fibrer)
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